Proximal humerus open reduction internal fixation with and without biceps tenodesis: assessment of early clinical outcomes

Michael A. Stone, MD; Harin Parikh, MD; Lukas Foster, MD; Adam Wright-Chisem, MD; Brett Ewing, MS; Amir H. Karimi, BS; Joshua Langberg, BS

JSES International (Jul 2024)

Proximal humerus open reduction internal fixation with and without biceps tenodesis: assessment of early clinical outcomes

Michael A. Stone, MD,
Harin Parikh, MD,
Lukas Foster, MD,
Adam Wright-Chisem, MD,
Brett Ewing, MS,
Amir H. Karimi, BS,
Joshua Langberg, BS

Affiliations

Michael A. Stone, MD: Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Corresponding author: Michael A. Stone, MD, Department of Orthopedics, Cedars-Sinai Medical Center, 444 S San Vicente Blvd, Los Angeles, CA 90048, USA.
Harin Parikh, MD: Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Lukas Foster, MD: Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Adam Wright-Chisem, MD: Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Brett Ewing, MS: Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
Amir H. Karimi, BS: Case Western Reserve University School of Medicine, Cleveland, OH, USA
Joshua Langberg, BS: Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Herbert Wertheim College of Medicine, Miami, FL, USA

Journal volume & issue: Vol. 8, no. 4
pp. 751 – 755

Abstract

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Background: The role of biceps tenodesis (BT) during open reduction internal fixation (ORIF) of proximal humerus fractures (PHFs) remains unclear. A subset of patients undergoing ORIF have persistent pain with unclear etiology. The purpose of our study was to compare outcomes of ORIF of PHFs with and without concomitant BT. We hypothesize patients undergoing BT at the time of ORIF will have improved patient-reported outcome scores with fewer secondary procedures related to treatment of the biceps. Methods: In this retrospective cohort study, all patients undergoing ORIF for a PHF at a single level one trauma center from January 2019 to June 2022 were reviewed. Patients under the age of 18 were excluded. Primary outcomes were patient-reported outcomes measurement information system physical function, depression, and pain interference scores at 5 time points up to final follow-up. Secondary outcomes included total operative time, complications, subsequent procedures, steroid injections, and range of motion. Chi-square tests were performed for categorical values and paired t-tests for continuous variables. Results: 71 patients met inclusion criteria: 41 undergoing ORIF without BT and 30 undergoing ORIF with BT. Average follow-up was 11 months. There were no statistically significant differences in patient demographics between groups. There were no differences in patient-reported outcomes measurement information system scores at any time point postoperatively. At final follow-up patients in the ORIF with BT group had higher forward flexion than those who did not undergo BT (142 vs. 123 degrees, respectively, P < .02). There were no differences in surgical time, revision rates, postsurgical complications, or postoperative injections between groups. Conclusion: BT performed during ORIF of PHFs did not result in significantly different functional or patient-reported outcomes between groups, except for greater forward flexion at final follow-up. Although BT was done more commonly in severe PHFs, patients in both groups had similar rates of subsequent biceps-related procedures and revision surgery.

Published in JSES International

ISSN: 2666-6383 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery: Orthopedic surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the musculoskeletal system
Website: https://www.journals.elsevier.com/jses-international

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